Participation in the rapid diagnostic test

We require the following information so that we can send you your individual results within 3 workdays. If you are interested in having a free-of-charge feedback dialog, simply give us your phone number so we can arrange a date and time.

This question must be answered.

Name, Surname:

E-mail:

I've read the privacy policy. I agree, that my data will be collected and stored electronically to respond to my enquiry.

Phone number

Position:

Industrie:

Number of employees:

The information you provide is subject to the strictest anonymity and confidentiality standards and will be treated in compliance with the applicable privacy provisions. Your data will not be passed on to third parties and all person-specific information provided will be deleted within two weeks after the results have been analyzed.

Instructions

Please estimate the extent to which the statements on the following pages apply to your company or organization. For your estimate, choose from the scale shown below, which ranges from “Does not apply” to “Applies completely”.Simply click the desired position on the scale to provide your answer.